Provider Demographics
NPI:1124731104
Name:DIRECT 2 HOME CARE LLC
Entity type:Organization
Organization Name:DIRECT 2 HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BENJMAIN
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:HOLLAWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-914-1681
Mailing Address - Street 1:17663 W 10 MILE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-2756
Mailing Address - Country:US
Mailing Address - Phone:248-914-1681
Mailing Address - Fax:
Practice Address - Street 1:17663 W 10 MILE RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-2756
Practice Address - Country:US
Practice Address - Phone:248-914-1681
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-04
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty